JPS6150452B2 - - Google Patents

Abstract

The relief suture set comprises two composite plates (10) which each consist of a relatively firm support plate (12) and a relatively flexible cushion plate (11). These two plates are firmly and flatly joined together. They have slits into which a wire (21) may be laterally inserted. The slits open into holes (17) which are located along the longitudinal centre axis of the composite plate (10) and the slits of a pair of slits run towards each other under an acute angle, so that they open into the same opening region on the side edge (13) of the composite plate. Each end of the wire may be clamped in a respective needle. <IMAGE>

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention provides two relatively rigid cushioning plates having a slit extending open from a longitudinal centerline toward one side and underlain by a cushion plate. A surgical relief suturing set comprising an elongated application plate and a wire or thread connected at least one end to a needle and inserted into the slit from the side.

After open surgery, it is known to provide additional relief suture sets to cushion the postoperative wound and prevent abdominal tearing. A known relief suture set used for this purpose consists of two application plates with underlying cushion plates, which are applied to the skin on either side of the patient's postoperative wound. [“Der Chirurg”, no.
50, p. 188 (1979)]. This application plate with cushion plate has side slits for introducing the wires.
This wire, which is inserted into a plastic casing and whose end is attached to a needle, provides the suture material for the relief suture.

Other known relief suture sets have several holes for inserting wires instead of a slit along their longitudinal centerline. In both cases, the cushion plate and the application plate are separated from each other and are only brought together during the relief stitching.

It is an object of the invention to provide a relief suture set of the type described above which is easy to handle for the surgeon and reduces the risk of complications for the patient.

According to the invention, this object has been achieved by connecting each application plate flatly and rigidly with the cushion plate in question.

In the present invention, only two suturing plates are required to perform relief suturing, instead of a total of four plates as in the prior art. Two composite plates, consisting of a relatively rigid application plate and a relatively flexible large cushion plate, are applied to the patient's skin with the cushion plate facing down, allowing the wires to be pulled through the abdominal wall. It has the advantage of being able to be moored. Therefore, the surgeon does not have to work with four plates, but can work with only two plates, which greatly improves work efficiency.

Another advantage is that the risk of contamination of the patient is reduced because no foreign matter or moisture can settle between the flat-bonded application plates and the cushion plates. The two plates may be joined, for example, by hot lamination (flame lamination), adhesive, or the like. It is important that the plates be firmly and permanently bonded, preferably over the entire area of the two mutually bonded surfaces.

The two joined plates of materials of different hardness are preferably manufactured from the same base material, for example polyethylene. In this case, the application plate may be a solid material and the cushion plate may be a foam material. Compared to conventionally used rubber cushion plates, plates made of foam material have better conformability to the skin and greater flexibility, thus avoiding inflammation and pressure gangrene.

The joining surfaces of the application plate and the cushion plate may be made coincident. On the other hand, the area of the application plate may be smaller than the area of the cushion plate. In the latter case, the cushion plate projects beyond the application plate to avoid the risk of stress gangrene due to the application plate. In a suitable embodiment of the invention, the application plate is received at least partially submerged within a recess in the cushion plate.

The application plate and/or the cushion plate suitably have rounded edges, thereby avoiding irritation due to friction caused by the edges of the plate.

In known relief suture sets, the side slits of the plate extend from one side edge parallel to and obliquely to the longitudinal centerline of the plate. In this arrangement, the direction of introduction of the wire into the slit is always the same. According to a preferred embodiment of the invention, in order to diversify the introduction of wires into the slits, the slits extend obliquely to the side edges of the application or cushion plate, so that two adjacent slits have an acute angle. In addition, they are arranged in pairs so as to be opened so as to approach each other toward the side edges. Depending on the length of the wound, this slit arrangement of the plate allows adjustment of the wire spacing so that the tissue can be partially loosened. Furthermore, this slit arrangement is advantageous for introducing the wire into the slits, especially when the wedges formed between adjacent slits are retracted from the side edges. In this case, the enlarged inlets are provided at the opening points of the two slits.

According to a preferred embodiment of the invention, the core of the wire consists of a number of monofilaments and is sheathed with a plastic casing. This ensures high flexibility of the wire as well as high tensile strength, compatibility with the tissue and non-cutting tissue penetration, without capillary effects.

Preferably, the core of the wire is tightly clamped within the clamping socket of the needle, the outer diameter of the clamping socket being approximately the same size as the outer diameter of the casing. In this way, a continuous transition between the needle and the wire takes place.

Since the external surface of the casing is aligned with the external surface of the needle clamping socket, unnecessary damage to the tissue during relief suturing is avoided.

Hereinafter, embodiments of the present invention will be described in further detail based on the accompanying drawings.

FIG. 1 is a plan view of the composite plate.

FIG. 2 is a plan view of the relief suturing set including two composite plates and wires in use.

FIG. 3 is a schematic longitudinal sectional view of the composite plate of FIG. 1.

FIG. 4 is a schematic longitudinal sectional view of another embodiment of the composite plate.

FIG. 5 is a schematic longitudinal sectional view of a third embodiment of the composite plate.

6 to 8 are schematic longitudinal sectional views of the edge region of yet another embodiment of the composite plate.

FIG. 9 is a plan view of the wire with needles attached to both ends.

FIG. 10 is a schematic longitudinal sectional view of the transition area between the wire and the needle.

Composite plate 10 shown in FIGS. 1 and 3
includes a cushion plate 11 and an application plate 12. The joining surfaces of plates 11 and 12 forming composite plate 10 are coincident. Composite plate 10 is elongated and has parallel side edges 13 and 14 and semicircular fronts 15 and 16. Several holes 17 are equally spaced along the longitudinal centerline of the composite plate 10 and extend through the entire thickness of the composite plate. slits 18 and 18' each extend from each circular hole 17 through the entire thickness of the composite plate to one side edge 13;
The edge is opened toward the outside. The slits 18 and 18' are arranged in pairs to form a wedge 19 with an acute angle. The ends of the wedge are slightly set back from the side edges 13 so that the outer ends of the slits 18 and 18' forming a pair of slits form a relatively wide open area 20 which extends towards one side of the strut. facilitates wire insertion from the side.

In the embodiment shown in FIG. 1, there are a total of six holes 1.
7, so there are a total of 3 sets of slits 1
8 and 18' are formed.

FIG. 2 shows two composite plates 10 belonging to a relief suture set. These composite plates 1
0 are placed with the cushion plate 11 down and spaced from each other on either side of the surgical suture (not shown) and applied to the patient's skin. The side edges 13, through which the slits 18 and 18' are respectively open, face outwards in each plate, that is to say in a direction away from each other.

A wire 21, which will be described in more detail below, is inserted into either of the slits 18 and 18' from the side, respectively. Wire 21 is inserted through the patient's abdominal wall using a needle and positioned, for example, as shown in FIG.

In the embodiment of FIG. 4, application plate 121 occupies a smaller area than cushion plate 11. In the embodiment of FIG. However, the holes 17 and slits 18 and 18' extend through both plates 11 and 121 as in the embodiment of FIGS. 1-3.

In the embodiment shown in FIG.
12 has an application plate 1 on the top thereof.
22 has a recess or hollow 22 into which it is fitted and inserted. In this arrangement, the cushion plate 1
The area of 12 is of course larger than the area of the application plate 122, and the thickness of the cushion plate is also larger than the thickness of the application plate.

After the stretched support suture is secured, the patient may experience some discomfort due to friction of the plate edges against the skin or gangrene formation from the plate. Therefore, it is preferred that at least the edges of the lower periphery of the cushion plate be rounded. 6 to 8 show embodiments of the embodiments of FIGS. 3 to 5 with rounded edges.
In FIGS. 6 and 7, the upper side edges of application plates 12 and 121 are also rounded, respectively.

In the illustrated embodiment, the base material of the cushion plate and application plate is polyethylene. However, application plates 12, 121 and 122 are made of solid material, whereas cushion plates 11 and 112 are made of foam material. Each cushion plate is bonded over its entire surface to the application plate by hot lamination, for example by flame lamination. The hard plate and cushion plate are made into hole 1 by injection molding, punching, etc. separately.
7 and slits 18 and 18' may be preformed and then joined by hot lamination, for example by flame lamination, or other joining techniques.

Depending on the manufacturing method, the contours, the holes 17 and the slots 18 and 18' can be punched out after the large-area plate profiles have been joined together, and the punched-out surfaces can then be smoothed, for example by heat treatment. The edges of the holes and slits are beveled outward.

9 and 10 show the wire 21. FIG. This wire is flexible and has curved rigid needles 23 connected to its ends. Each needle has a cylindrical clamping socket 25 at its rear end, the cross-section of which generally coincides with the cross-section of the remainder of the needle. The end of the wire core 24 is inserted into the clamping socket and tightened there. The cut end 26 of the wire core may be perpendicular to the axis of the wire core, but may also be at an angle of 80 DEG to 60 DEG to facilitate insertion into the socket.

The wire core 24 includes, for example, 19 monofilaments, 7 of which form the wire core and 12 of which form the wire seeds. The wire core is surrounded by a plastic casing 27 having a thickness of 0.35 mm. However, since the casing borders the clamping socket 25, only the wire core 24 is clamped within the clamping socket 25. The thickness of the clamping socket 25 generally corresponds to the thickness of the casing 27 so that no discontinuity point is formed at the transition point between the casing 27 and the clamping socket 25.

[Brief explanation of the drawing]

FIG. 1 is a plan view of the composite plate. FIG. 2 is a plan view of a relief suturing set including two composite plates and wires in use. Third
The figure is a schematic longitudinal sectional view of the composite plate of FIG. 1. FIG. 4 is a schematic longitudinal sectional view of another embodiment of the composite plate. FIG. 5 is a schematic longitudinal sectional view of a third embodiment of the composite plate. 6 to 8 are schematic longitudinal sectional views of the edge region of yet another embodiment of the composite plate. FIG. 9 is a plan view of the wire with needles attached to both ends. FIG. 10 is a schematic longitudinal sectional view of the transition area between the wire and the needle. 10 is a composite plate, 11 and 112 are cushion plates, 12, 121 and 122 are application plates, 13 and 14 are side edges, 15 and 16 are semicircular fronts, 17
18 and 18' are holes, 19 is a wedge, 20 is an opening area, 21 is a wire, and 22
is a recess or hollow, 23 is a needle, 24 is a core, 25
is the tightening socket, 26 is the cut end of the core, 27
indicates the casing.

Claims (1)

[Scope of Claims] 1. Two relatively rigid longitudinally extending applications that are lined with a cushion plate and have a slit that extends open toward one side from a longitudinal centerline. In a surgical relief suturing set comprising a plate and a wire connected to a needle at least one end and inserted into the slit from the side, each application plate 12 is firmly joined to the said cushion plate 11. A surgical relief suture set characterized by: 2. The relief suture set according to item 1, in which the joint surfaces of the application plate 12 and the cushion plate 11 coincide. 3. The relief suturing set according to item 1, wherein the area of the application plate 121 is smaller than the area of the cushion plate 11. 4. The relief suturing set of claim 3, wherein the application plate 122 is housed at least partially submerged within the recess 22 of the cushion plate 112. 5. The relief suture set according to any one of items 1 to 4, wherein the application plate 12 and/or the cushion plate 11 have rounded edges. 6 The slits 18 and 18' extending obliquely toward the side edge 13 of the application plate 12 or the cushion plate 11 are arranged in pairs, and two adjacent slits 18 and 1
6. The relief suture set according to claim 1, wherein the relief suture set 8' has an acute angle and opens toward the side edges so as to approach each other. 7. The relief suture set according to claim 6, wherein the wedge 19 formed between the adjacent slits 18 and 18' is set back from the side edge 13. 8. Relief suture set according to any of the preceding clauses, wherein the core 24 of the wire 21 comprises a number of monofilaments and is sheathed by a plastic casing 27. 9 The core 24 of the wire 21 is the tightening socket 2 of the needle.
5, and the outer diameter of the tightening socket 25 is approximately the same as the outer diameter of the casing 27.
Relief suture set as described in section.